Project End Date (PED) - Extension Request

Submit this Form if your PED has Expired or is set to expire within the next 6 months.

This form is only to be used to extend the Project End Date and is not intended to replace any other submittal process.

Name of Individual submitting form

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Name of District Area Engineer if known. Otherwise leave blank

Area Engineer will be copied on request

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Indicate whether reimbursable work is currently being performed on the project.

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Examples of situations which may justify a revision to the PED include, but are not limited to: litigation, major changes in design, environmental or permit issues, construction claims, differing site conditions, significant additional work, area-wide material shortages, labor strikes, unusually severe weather, or other events which are outside the control of the LPA.

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Please limit Expanded Justification language to 2 or 3 sentences as appropriate.

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The Estimated Phase Completion Date is not the PED (see Note below).

Note: The PED is established by adding 12 months to the LPA's estimated date of completing the authorized phase of work (Date entered above).

Optional (Only use if required).

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I certify the justification and proposed Completion Date proposed in this form are valid, and the extension request is necessary.

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